The impact of hereditary TTP on psychological health, cognition, and well-being: a patient-reported outcomes study

遗传性TTP对心理健康、认知和幸福感的影响:一项患者报告结局研究

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Abstract

Hereditary thrombotic thrombocytopenic purpura (hTTP) is a rare inherited blood disorder caused by severe ADAMTS13 deficiency due to biallelic ADAMTS13 mutations, leading to life-threatening complications across the life span. Its impact on long-term psychological, cognitive, and overall well-being remains poorly understood. This study evaluated patient-reported outcomes in individuals with hTTP, comparing them to the general US population and patients with other chronic conditions, and assessed changes over time. Patients enrolled in the International Hereditary TTP Registry completed Patient-Reported Outcomes Measurement Information Systems assessments of fatigue, depression, anxiety, cognitive function, and positive affect. Repeat assessments were conducted 6 months and 1 year after the first assessment to assess changes over time. Mean scores were compared with the US population using 1-sample t tests, whereas a repeated-measures analysis of variance assessed changes over time. A literature search identified relevant comparison disorders. Twenty patients completed the baseline assessment, with 14 completing assessments at all 3 time points. At baseline, patients scored significantly worse than the US population on fatigue, depression, anxiety, and cognitive function, but positive affect scores were similar. hTTP scores were similar to, or worse than, scores from patients with immune-mediated TTP and other chronic diseases. No significant changes were observed over time. In conclusion, hTTP is associated with persistent patient-reported fatigue, depression, anxiety, and cognitive dysfunction. These findings highlight the chronic psychological impact of the disease and support the need for ongoing monitoring and early interventions to improve overall health and well-being.

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